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Friday, 7 October, 2016

Why we never noticed ZIKA?- Indian Research and Development

“Zika had 'disappeared' because it wasn’t worth worrying about and people weren’t paying attention.” Zika virus was first identified in 1947 in a sentinel monkey that was being used to monitor for the presence of yellow fever virus in the Zika Forest of Uganda. At this time cell lines were not available for studying viruses, so serum from the febrile monkey was inoculated intra-cerebrally into mice. All the mice became sick, and the virus isolated from their brains was called Zika virus. The same virus was subsequently isolated from Aedes africanus mosquitoes in the Zika forest.

In 1950, when some serological studies were being done, it was found that we humans developed antibodies against this virus. Further studies revealed evidence of infection in other African countries, including Uganda, Tanzania, Egypt, Central African Republic, Sierra Leone, and Gabon, as well as Asia (India, Malaysia, Philippines, Thailand, Vietnam, Indonesia). The virus circulating in Brazil is an Asian genotype, possibly imported during the World Cup of 2014. As of this writing Zika virus has spread to 23 countries in the Americas.

India is vulnerable to Zika virus outbreak as the species of mosquito, Aedes aegypti, which carries the virus, is found across the country. It's the same mosquito that carries the viruses of Dengue and Chikungunya. The prevalence in the country of dengue and chikungunya can make it hard to gauge Zika’s prevalence early.

Dire need to digitize records and report early- The baseline prevalence of congenital microcephaly is difficult to determine because of underreporting, and the inconsistency of clinical criteria used to define microcephaly. Although population-based estimates of congenital microcephaly in Brazil vary, the number of infants with microcephaly currently being reported in Brazil is greater than would be expected???

During the first week of infection, Zika virus can be found in the blood and can pass from an infected person to another mosquito through mosquito bites. An infected mosquito can then spread the virus to other people. To help prevent others from getting sick, avoid mosquito bites during the first week of illness by strictly following steps to prevent mosquito bites.

Advanced Disease Analytics It is very hard to prove the linkage between Zika virus and microcephaly cases. The proposed link between Zika and microcephaly began taking shape in September after some pediatricians in northeast Brazil noticed an unusual number of babies born with microcephaly. This spike in microcephaly cases coincided with an outbreak of Zika, a virus related to the dengue virus and spread by mosquitoes, and when a task force set up a registry to track the problem, it discovered that in 26 of the first 35 cases entered, the mother had developed an illness with a rash potentially indicative of Zika during her pregnancy.

But confirming a link between Zika and microcephaly will take more research and time — months, if not years — and the confirmation may end up as a preponderance of evidence rather than a definitive link. What’s easy to forget about the oft-cited scientific mantra, correlation is not causation, is that causation is incredibly difficult to prove. When you’re a doctor who’s seeing an alarming number of infants born with birth defects, correlation may be all you have to go on.

Hope: There are currently no antiviral drugs or vaccines that can be used to treat or prevent infection with Zika virus. We do have a safe and effective vaccine against another flavivirus, yellow fever virus. Substituting the gene encoding the yellow fever E glycoprotein with that from Zika virus might be a good approach to quickly making a Zika vaccine. However, testing of such a vaccine candidate might require several years.

Hyderabad based lab claims breakthrough achievement in developing world's first Zika vaccine- Bharat Biotech, a Hyderabad-based vaccines and bio-therapeutic manufacturer, on February 3, claimed to have achieved a breakthrough in developing a vaccine to fight the dreaded mosquito-borne Zika virus. The two candidate vaccines are in an advanced stage of development and could be ready soon after pre-clinical studies are concluded in the next five months.

The World Health Organisation (WHO) has issued the Pre-qualification of Medicines Programme (PQP) certification to Chennai-based Green Signal Bio Pharma. The pharmaceutical company got the certification to manufacture a Bacillus Calmette-Guerin (BCG) vaccine, with which, it became the only Indian company to get PQP certification from WHO.

Zika virus has never been isolated in India. The only time any trace of the virus was recorded in India was in 1952-53. A study titled ‘Neutralising antibodies against certain viruses in the sera of the residents of India’, published in a journal called The Journal of Immunology, recorded among other viruses, antibodies to the Zika virus. The study, which went to 38 localities in six states in India, tested 15 vector borne viruses. “Significant numbers of the sera neutralised Zika,” noted the study authored by “KC Smithburn of the Rockefeller Foundation in New York, JA Karr, director, virus research centre in Poona and PB Gatne, Medical offer, Bombay State India.

Remember:

The Zika virus is heat-driven. The hotter it is, the more effectively the mosquitoes are able to spread diseases. India is a favorable climate.

India is one of the countries where Aedes Aegypti - the mosquitoes that transmit both Dengue and the Zika virus are extremely prevalent.

Storage of drinking water and other urban water, containers including plant-pot bases, guttering, tarpaulins and tyres and discarded containers can all collect rainwater and provide habitat for Aedes aegypti larvae.

Aedes aegypti

Is a domestic mosquito

Generally, lives indoors and near people

Rests in cool shaded places in houses such as in wardrobes, laundry areas and under furniture

Is hard to catch and moves very quickly, darting back and forth

Often bites around your feet and ankles, and may bite repeatedly

Has a bite that is often relatively painless, so you may not notice you are being bitten or you may think you are being bitten by sandflies or biting midges

Feeds during daylight hours. Biting activity is higher in the two hours after sunrise or before sunset, but they will bite throughout the day. As a result, bed nets do not prevent dengue transmission.

Stepping up action against Zika virus, Health Ministry on Monday said 10 new diagnostic facilities will become operational in different states by the end of February. In addition to the two diagnostic facilities at NCDC and National Institute of Virology (NIV) Pune, 10 new facilities will become operational by end of February. These are located in Tamil Nadu, Kerala, Puducherry, Karnataka, West Bengal, Uttar Pradesh, Gujarat, Madhya Pradesh, Odisha and Assam.

As a precaution, all aircraft are being disinfected as per the WHO guidelines. In addition, vector breeding in containers at the seaports is also being taken up and National Vector Borne Diseases Control Program and National Centre for Disease Control are checking for control of vector densities. Surveillance activities have been activated through the Integrated Disease Surveillance Programme (IDSP) network along with Rapid Response Teams in states. So far no Zika case has been reported in India. We urge the common public to keep a watch and report every Zika case to RRT teams in every state.

As Zika heads to India, an older strain in Indians prepare for a second coming- A virulent version of the Zika virus that has swept the globe is headed for India, where an older, more benign strain is likely to be quietly residing within some Indians, possibly preparing genetic ground for a quick, new second-coming, experts have warned.

In India, the Zika virus – which has no cure or vaccine – was first found in Pune 64 years ago, as part of a survey that was testing immunity to Japanese and Russian varieties of a virus-borne brain infection called encephalitis, according to a forthcoming paper authored by World Health Organisation (WHO) scientists.

The paper comes soon after this study in the Lancet, a medical journal, which used travel patterns to predict that India – where more than 67,000 air travellers arrive every year – and four other countries (China, Philippines, Indonesia and Thailand) were most at risk for year-round transmission of the Zika virus. China has more people, but more people are at risk in India. Read more>>

Chinkungunya wasn’t supposed to be in India; then it showed up

Zika’s cousin, chikungunya, first had a major outbreak across India – barring Kerala which had no Aedes aegypti mosquitoes then – between 1964 and 1967.

Chikungunya faded from public and scientific memory, and when it returned in 2002, “we were caught with our collective pants down”, said T Jacob John, a retired virologist who, along with two colleagues, documented India’s first HIV infection in 1986, and designed a national response.
The second coming of chikungunya in India came through a mutated and more virulent virus, John noted. “We missed a golden opportunity to document all that.”Referrring to Zika, John described the feeling as “deja vu chikungunya”.